Good nutrition and exercise are common basics for advice when it comes to alleviating various concerns like fatigue, anxiety, heart disease and cancer, to name a few. However, our health status is also related to both where and how we live. Weight gain, and the inability to lose weight is an extremely prevalent topic as various diets have appeared over the many decades, yet obesity in the U.S. has tripled. Endocrine disrupting chemicals (EDC) are materials present in our daily life that interfere with progesterone, testosterone and most commonly, estrogen signaling. Hormones in balance help alleviate the concerns listed above, as well as offer prevention against them, and many hormone-related concerns (i.e. hot flashes, heavy menses, pre-menstrual syndrome, acne, infertility, low libido). In addition to EDCs, there’s also a class of chemicals called obesogens, which interfere with our metabolism, namely fatty acid oxidation. These chemicals can also get stored in fat cells, literally making us toxic, and alter our genetic capability for optimal metabolism. These products typically occur in small amounts in the environment, yet it is the constant exposure from many items both outside and inside our home, in addition to exposure even as a fetus (chemicals have been found in the umbilical cord), that warrants delving into identifying these products and then replacing with safer options.
Before the industrial revolution (around the 1930s and 40s), one constituent usually caused a disease, which was then typically cured by a treatment, such as an antibiotic getting rid of a bacterium. Soon food became mass-produced in many types of ways (i.e. hormones, antibiotics, pesticides), and cars and power plants greatly increased contributing to decreased air quality. Around the 1970s, physicians and researchers began to link various chemicals with rare cancers and hormone-related issues (i.e. infertility) in humans and wildlife, most notably diethylstilbestrol (DES) where children of mothers who took DES in pregnancy are at increased risk for certain cancers of the reproductive organs, as well as malformations.1 There are more than 1,400 EDCs, and this number is expected to rise.2
EDCs exert a variety of effects on the body’s signals, receptors and genetic make-up as it’s almost like a whole other organ system outside the body, therefore contributing to the holistic approach to treating a person’s concerns. Our predisposition for fat cells starts as we are in the womb, yet with cord blood displaying evidence of EDCs and increasing prevalence of obesity early on, suggests a link between how early this predisposition to obesity in adulthood can begin. Estrogen has been shown to play an important role in the number of adipocytes in adults (as research suggests we are born with a certain amount of fat cells), being able to both produce and halt production of fat cells. However, too much or too little can have the opposite effect, such as weight gain.3 Further, fat cells are also their own endocrine organ that are comprised of numerous other receptors besides estrogen, and exert effects on the body such as managing blood sugar, hormone balance, and satiety.4 Increased adipocyte size due to EDC exposure (and holding in toxins) can also alter the signals that ultimately help support a healthy appetite such as insulin resistance (sugar can’t get into cells) and a balance between leptin (tells us we’re full) and ghrelin (tells us we’re hungry), as obesity has been linked to high leptin due to resistance. If we constantly feel hungry and our body doesn’t recognize there’s sugar around as insulin can’t get inside the cell, we tend to crave more sugar/fats, perhaps more processed foods, all of which can worsen estrogen and insulin levels.
Bisphenol A (BPA) is a popular constituent in polyvinyl chloride (PVC), which utilizes plasticizers to increase its flexibility, yet these have been linked to interference with estrogen signaling and thyroid function.5 PVCs are found in pipes, cables, roofing, medical products, toys, food packaging and bottles, the more popular culprit of locating BPA. It is one of the most studied EDC and highest produced chemicals, found in the blood of human fetuses, has actions similar to estradiol, as well as contributes to obesity by increasing genes such as 3T3-L1 (differentiate into adipocytes) and GLUT4 (transport glucose into cells). Estrogen in balance can block peroxisome proliferator-activated receptor (PPAR) gamma so differentiation does not occur, as well as help someone become more insulin sensitive, yet when out of balance (i.e. through EDCs), it can cause issues.3 The vaginal canal is also extremely sensitive to EDCs as the skin is about four times more absorptive than our thinnest skin, and can be exposed to tampons and pads, as well as douches, wipes and powders, especially in the black and Latina community. Dioxins are commonly found in tampons and pads, and while alone they are found in trace amounts, a woman who uses tampons in her menstrual life can use approximately 11,400—which is 11,400 exposures to dioxins.6 According to the World Health Organization, dioxins are environmental pollutants with 90 percent of human exposure through food (mainly meat, dairy, fish and seafood), and have a high affinity to be stored in fat tissue, ultimately affecting hormone signals.7 Below is a graphic below of where some of these chemicals listed, and common others ones too, are located in our day to day life:
When it comes to addressing these concerns and determining someone’s toxic load, special testing such as urine testing for the breakdown of estrogens (a 2-, 4- and 16-OH to MeOH version) and other hormones can be helpful. For example, the “2” version is protective, the “16” version can be in small amounts, but better in a good ratio with “2”, and the “4” version indicated their xenoestrogen load. Optimizing bloodwork as well can be helpful in achieving personal health goals. Replacing regularly used cleaning and beauty products with allergen-friendly (i.e. gluten free, vegan, free of chemicals) products, and tampons with a Diva cup (or similar) or organic cotton, can also reduce toxic load. While we cannot be toxin free—our body is made to detox—we can certainly help it along by removing some body burden and nourishing ourselves through diet, lifestyle, and supplements.
Foods such as cruciferous vegetables especially contain a sulfur compound that helps the liver with detoxification, and will also contain adequate fiber to feed good gut bacteria promote healthy bowl movements (amongst many other benefits) to eliminate toxins. In addition, consuming whole foods, and especially a rainbow of vegetables, are important in getting adequate antioxidants to promote optimal detoxification pathways in the liver. Urinating, sweating (i.e. exercise, sauna, steam) and crying (emotions are stored in our cells) are all common ways to release water, another common way to get eliminate toxins, so replenishing with at least half your body weight in ounces of water (ideally filtered), perhaps more if exercising, to continue this process. Lifestyle choices to reduce or eliminate alcohol, regular exercise, choosing quality meats, and finding time for yourself to de-stress and enjoy hobbies, are all part of helping the body be as efficient as possible.
Toxins can increase inflammation in the body, so ensuring the body can handle this stress and eliminate help focus therapies around adrenal and liver support. Magnesium is involved in more than 500 reactions, many of which are important in both detoxing estrogens and removing chemicals from the body. Further, it is commonly depleted by everyday activities such as alcohol, stress and caffeine. Calcium-d-glucurate helps improve gut clearance of estrogen, while DIM (more stable than indole 3 carbinol), naturally obtained in cruciferous vegetables, further helps the body detox xenoestrogens and promotes a healthy balance of estrogen levels. As most detoxification happens in the liver, milk thistle is a wonderful herb that helps liver cells regenerate, as well as act as a diuretic to ensure proper elimination. Consider speaking with an integrative or naturopathic doctor on a proper plan, as well as potential herb/drug/nutrient interactions.
It’s imperative to understand the person sitting in front of you and their largest obstacle to cure, and to what degree and emphasis you want their efforts being utilized. However, while this may seem like a lot of work, getting that foundation of healthy coping mechanisms, a rainbow of vegetables in their diet, and healthy lifestyle and environment, will not only help improve their main concerns and minimize their exposure, but also double as preventative care for future disease risk.
References:
1 Schug, T., et al. (2016). Endocrine disruptors: Past lessons and future directions. Molecular Endocrinology. 30(8):833-847. www.ncbi.nlm.nih.gov/pmc/articles/PMC4965846/.
2 Lee, D. (2018). Evidence of the possible harm of endocrine-disrupting chemicals in humans: Ongoing debates and key issues. Endocrinology Metabolism (Seoul). 33(1):44-52. www.ncbi.nlm.nih.gov/pmc/articles/PMC5874194/.
3 Saal, F., et al. (2012). The estrogenic endocrine disrupting chemical bisphenol A (BPA) and obesity. Molecular Cellular Endocrinology. 354(1-2):74-84. www.ncbi.nlm.nih.gov/pmc/articles/PMC3306519/.
4 Rosell, M., et al. (2014). Brown and white adipose tissues: intrinsic differences in gene expression and response to cold exposure in mice. American Journal of Physiological Endocrinology Metabolism. 306(8):E945-E964. www.ncbi.nlm.nih.gov/pmc/articles/PMC3989735/.
5 Ghisari, M., & Bonefeld-Jorgensen, E. (2009). Effects of plasticizers and their mixtures on estrogen receptor and thyroid hormone functions. Toxicology Letters. 189(1):67-77. www.sciencedirect.com/science/article/pii/S0378427409002537.
6 Scott, R. (2014). Chemicals in feminine hygiene products and personal lubricants. Environmental Health Perspectives. 122(3):A71-A75. https://ehp.niehs.nih.gov/doi/pdf/10.1289/ehp.122-A70.
7 World Health Organization (2016). Dioxins and their effects on human health. www.who.int/news-room/fact-sheets/detail/dioxins-and-their-effects-on-human-health.
Serena Goldstein, ND is a naturopathic doctor in New York, NY specializing in hormonal concerns such as weight, mood, stress, PMS, peri/menopause and andropause. Dr. Goldstein creates customized plans utilizing nutrition, botanical medicine and homeopathy, while educating her patients around conventional care and supplements to address symptoms and then discover how and when they feel their best. She believes in instilling a proper foundation of health through diet, sleep, stress and lifestyle as any form of medicine should supplement, not replace, an unhealthy lifestyle. Dr. Goldstein has been published in well-known health and wellness resources, such as MindBodyGreen, Better Nutrition and Bustle, and spoken at places such as Lehman College and the American Cancer Society. Dr. Goldstein also lends her expertise to fellow doctors at NYU-Hospital Poison Control Center.
